Adult and Child > 20 kg: 4cc per kg per percent burn (Give half of the fluid over first eight hours, the other half over the next 16 hours.)

A child less than 20 kg: 3 cc per kg per percent burn (Give half of the fluid over the first eight hours, the other half over the next 16 hours. Add maintenance rate using D5LR and divide evenly over 24 hours.)

Maintenance formula:

100 cc per kg for first 10 kg of body weight

50 cc per kg for second 10 kg of body weight

Foley catheter

Adjust IV rate to maintain urine at 30–50 cc per hour in adults and one cc per kg in children. For electrical burns with myoglobin (dark urine), maintain urine at 100 cc per hour.

Nasogastric tube

Use for BSA > 25 percent burns or intubated patients.

Pain management

Use IV morphine.

Chemical burns

Remove clothing, dust off powdered chemicals then flush all areas with water for at least 30 minutes.

Wound care

Cover with a clean, dry sheet and keep patient warm.

Exercise caution if using wet compresses — may result in hypothermia.

Elevate upper extremities if burned.

History

Obtain history of mechanism of injury and pertinent past medical history.